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Individual

CHRISSIE OTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2906
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00046732
WA
207R00000X
Internal Medicine Physician
MD27866
OR
208000000X
Pediatrics Physician
MD00046732
WA
208000000X
Pediatrics Physician
Primary
MD27866
OR
208M00000X
Hospitalist Physician
MD27866
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500632501
OR
Enumeration date
07/13/2006
Last updated
02/15/2021
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